PROJECT SUMMARY/ABSTRACT The overarching goal of the proposed research is to study further aspects of health coaching, an intervention that led to the first randomized evidence that health coaching reduces re-hospitalizations in chronic obstructive lung disease (COPD). The proposed study of the mechanistic effect of this intervention will lead to the creation of a theoretical framework of how the intervention works. We will further test the effect of health coaching on the quality of life and daily physical activity of a patient with severe symptoms of COPD in a small but powered randomized study. General goals: The proposal will provide Roberto Benzo, MD, MSc, with protected time to extend his mentorship of junior future NHLBI researchers and also expand his research program. Specific aims: Dr. Benzo plans to increase his time mentoring investigators from the Pulmonary Medicine and Critical Care Program at Mayo Clinic, students from the Mayo Clinic Graduate School of Biomedical Sciences, and Mayo Center for Clinical and Translational Science scholars. He will also perform the mechanistic analysis of his recent NHLBI-funded randomized study identifying the benefits of health coaching which decreases hospitalizations for COPD and expand the study of the effectiveness of health coaching in another disease group. Qualifications: Dr. Benzo is a tenured Associate Professor at Mayo Clinic, with a strong record of research, publication, and mentoring. His K23 career development award, training in epidemiology at Harvard University, two subsequent R01s, and multiple SBIRs have developed his background as an ideal candidate for this application. He currently leads the Mindful Breathing Lab at Mayo Clinic, an NIH-funded lab devoted to patient-oriented research in lung disease. Environment: The proposed K24 grant will be executed through the Division of Pulmonary and Critical Care at Mayo Clinic, which was ranked #1 in the United States in the last two consecutive years by the U.S. News & World Report. Mentoring program: Dr. Benzo presently mentors junior faculty, pulmonary and critical care fellows, resident physicians, and graduate students. Several mentees are engaged in NHLBI research, including one who was recently awarded a K23 from the NHLBI. Mentees: Dr. Benzo will solidify and expand his mentoring program with the assistance of this grant. The program's resources and reputation will attract an increasing pool of the most qualified and promising future NHLBI researchers. Training: Dr. Benzo will undertake substantive training to plan, execute, and analyze patient- oriented studies. Research: The proposed research will build on Dr. Benzo's previous work, especially the published findings of his recent NHLBI-funded R01 study. Significance: This grant will facilitate the development of the next generation of NHLBI patient-oriented researchers and will support the ongoing research implementing the intervention that focuses on what matters to patients.